The pathogenesis of irritable bowel syndrome(IBS) has not been fully elucidated. Abnormal gastrointesti-nal dynamics and visceral hypersensitivity were its main pathophysiological basis. Abnormal expression of neu-ropeptides can affect the visceral sensation, secretion and movement, leading to the occurrence of IBS. This article reviewed the relationship between neuropeptides and IBS from the following neuropeptides: 5-hydroxytryptamine (5-HT), corticotropin releasing factor (CRF), vasoactive intestinal peptide (VIP), substance P (SP), and somatostatin (SS). It provided reference evidences for the elucidation of IBS pathogenesis.

Objective To study the views of clinical nursing staff about current nursing quality evaluation so as to find the problems in nursing quality evaluation.Method 25 head nurses and nurses were interviewed using semi-structured open interview about nursing quality evaluation.Result The current nursing quality evaluation system was lower in sensitivity,focusing more on nursing skills but less on nursing evaluation of nursing specialties.Conclusions The system of current nursing quality evaluation lacks of nursing evaluation of nursing specialties and therefore cannot meet the requirements for the development of nursing specialty. Therefore,it is urgent to regulate an evaluation system for nursing specialties.

Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.

OBJECTIVE:To compare clinical efficacy and safety of olanzapine and quetiapine for mental disorders elderly pa-tients. METHODS:120 elderly patients with mental disorders were randomly divided into olanzapine group and quetiapine group, with 60 cases in each group. Olanzapine group was given Olanzapine tablet orally with initial dose of 2.5 mg,qd,and then increas-ing to maximal dose 15 mg according to disease condition,qd;quetiapine group was given Quetiapine tablet orally with initial dose of 50 mg,qd,increasing to maximal dose 400 mg according to disease condtion,qd. Both groups received 6 weeks of treat-ment. Clinical efficacy of 2 groups were compared as well as PANSS and the quality score of life before and after treatment,and the occurrence of ADR. RESULTS:PANSS and the quality score of life were improved significantly in both groups,with statisti-cal significance (P>0.05);but there was no statistical significance between 2 groups (P>0.05). There was no statistical signifi-cance in clinical efficacy between 2 groups(P>0.05). The incidence of lethargy,hypotension and bradycardia in quetiapine group were significantly lower than in olanzapine group,while the incidence of tachycardia was significantly higher than olanzapine group,with statistical significance (P<0.05). CONCLUSIONS:Olanzapine and quetiapine are similar to each other in the treat-ment of mental disorders elderly patients;both of them can effectively improve the quality of life,and ADR induced by quetiapine is slighter than that induced by olanzapine.

?AlM: To evaluate the expressions and significances of endoplasmic reticulum stress related protein ( BlP ) , hypoxia-inducible factor-1α ( HlF-1α) and vascular endothelial growth factor ( VEGF) in the retina of diabetic rats.
?METHODS:Seventy-two male Sprague-Dawley ( SD) rats were chosen and divided randomly into 6 groups:normal control 2mo (C2m, n = 12), diabetes mellitus 2mo (D2m, n=12), normal control 4mo (C4m, n=12), diabetes mellitus 4mo (D4m, n = 12), normal control 6mo (C6m, n=12) and diabetes mellitus 6mo (D6m, n=12 ) . The diabetes mellitus mouse were induced by intraperitoneal injection of 0. 1mol/L streptozotocin (STZ, 65mg/kg). The expression of BlP, HlF-1α and VEGF in the retina were detected by enzyme- linked immuno sorbent assay. The location of BlP, HlF-1α and VEGF in epiretinal membranes were investigated by immunohistochemistry staining.
?RESULTS: BlP were significantly increase than control groups in all DM groups with the course of diabetes ( P<0. 01). HlF-1α were detected higher than control groups in all DM groups (P< 0. 05), but there was no statistical significance among treatment groups. VEGF in D4m and D6m groups were higher than control groups (P<0. 05), and there was statistical significance between D4m and D6m groups. BlP can be detected in control groups a little, mainly in the inner limiting membrane and ganglion cell layers. HlF - 1α cannot be detected in control groups, meanwhile it can be detected in all layers in DM. VEGF can be detected in control groups a little, it mainly be detected in inner nuclear layer, outer nuclear layer, around retinal vessel and ganglion cell layers in DM groups.
?CONCLUSlON:The expressions of BlP, HlF-1α and VEGF increase in the retina of diabetic rats than control groups with progressive of diabetes mellitus, both endoplasmic reticulum stress and HlF-1α signal path play important role in the progress of diabetic retinopathy.

Doctor's degree is the highest degree for medical education.Nowadays,medical doctor candidates in more and more medical universities are requested to publish research papers in intemational journals embodied in Science Citation Index(SCI),or they can not graduate with doctor's degree.So,it is significant for medical doctor candidates to learn the related knowledge about SCI and Impact Factor(IF).

Objective To evaluate the in vivo efficacy of modified platelet(PLT) additive solution(PAS-ⅢM) with trehalose as a substitute for plasma for the storage of platelet concentrates at low temperature(10℃).Methods Rabbit platelet concentrates were collected and stored in different media and temperature conditions,plasma(22℃),70%PAS-ⅢM/30% plasma(10℃) and plasma/trehalose(-85℃).Platelets in plasma(22℃) on storage day 3,in 70%PAS-ⅢM/30% plasma(10℃) on storage day 3,7,9,and in plasma/trehalose(-85℃) thawed on day 20 were transfused to rabbit thrombocytopenia model.The in vivo recoveries and survivals of the three preserved platelets and fresh platelets were measured and evaluated after transfusion into rabit model of thrombocytopenia.Results The survival of platelets stored in 70% PAS-ⅢM/30% plasma(10℃) on day 9 was lower than that of fresh platelets(P0.05).Recovery and survival of frozen platelets were significant lower than those of the other groups(P

Synergetic antiplatelet effects of aqueous extracts of Fructus Crataegi and Rhizoma Alismatis in vitro were studied. The interaction of the two drugs was also observed. Results showed that the IC50 of Fructus Crataegi on platelet aggregation induced by ADP was 1.388g/100ml,whereas the IC50 of Rnizoma Alismatis was 7. 585g/100ml. In the presence of low concentrations of Fructus Crataegui (0.3~0.9g/100ml ),the an　tiplatelet activity of Rhizoma Alismatis was significantly increased,and the IC50 was only 1.755g/100ml with the presence of 0. 9g of Cralaegus pinnatifida per 100ml. These results suggested that the two drugs have a mutual synergetic effect on antiplatelet function

Animals ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Ventricular Remodeling

Converting two poorly water-soluble crystalline drugs to co-amorphous drug systems by ball milling, quench-cooling, or cryo-milling method can improve stability of the drug, enhance dissolution rates, and reduce adverse reactions of the single drug. Co-amorphous system has been used to solve problems of co-administration of medicines. Formation and intermolecular interactions of co-amorphous drug systems may be verified by differential scanning calorimetry (DSC), X-ray powder diffraction (XRPD), Raman spectroscopy (RS) and Fourier transform infrared spectroscopy (FT-IR). Stability of co-amorphous drug systems is influenced by their glass transition temperature (Tg) and intermolecular interactions. The theoretical Tg values and the interaction parameter x are calculated by Gordon-Taylor equation and the Flory-Huggins equation, respectively. Thus, co-amorphous drug systems are analyzed theoretically at molecular level. Co-amorphous drug systems provide a new sight for the co-administration of medicines.